Predictors of Cervical Lymph Node Metastasis in Patients with Squamous Cell Carcinoma of the Larynx

Objectives: In this retrospective study, we evaluated the effectiveness of the tumor volume, grade and invasion depth in the prediction of cervical lymph node metastasis.
Background: Identification of diagnostic parameters reliably predicting cervical lymph node involvement can be useful in improving the management of laryngeal cancer.
Material and Methods: One hundred and seven patients with squamous cell carcinoma of larynx and who underwent surgery were assessed retrospectively. Age, sex, Tumor-Node-Metastasis (TNM) stage, grade, invasion depth and tomography(CT) volume of the tumors were analysed. The association between these parameters and cervical lymph node metastasis was determined.
Results: Thirty two patients (%29.91) had positive cervical lymph nodes. Lymph node metastasis is detected in 13 (46.43%) poorly differentiated tumors, and in 19 (24.05%) moderate-well differentiated tumors. Mean volume was 2.15±0.14 cc in lymph node negative patients and 2.97±1.05 cc in lymph node positive patients. Mean invasion depth was 10.1±0.87 mm in lymph node negative patients and in 11.3±1.05 mm lymph node positive patients. The tumor grade and volume predicted successfully lymph node metastasis in patients with squamous cell carcinoma of the larynx, however invasion depth were not associated with nodal metastasis (p=0.047, p=0.0022, p=0.916, respectively)
Conclusion: The tumor grade and volume can predicted cervical lymph node metastasis in patients with squamous cell carcinoma of the larynx, whereas the depth of invasion did not. Calculation of the tumor volume radiologically can help predict lymph node metastasis by minimizing the variability in measurements such as the depth of invasion performed by pathologists.

Larenks Skuamöz Hücreli Karsinomu Olan Hastalarda Servikal Lenf Düðüm Metastazinin Öncü Ýþaretleri

Amaç: Bu retrospektif çalýþmada tümör hacmi, derecesi ve invazyon derinliðinin servikal lenf nodu metastazýný öngörmedeki etkinliðini deðerlendirdik. Servikal lenf nodu tutulumunu güvenilir bir þekilde öngören tanýsal parametrelerin tanýmlanmasý, laringeal kanserin yönetiminin iyileþtirilmesinde yararlý olabilir.
Gereç ve Yöntemler: Larenks yassý hücreli karsinomu nedeniyle ameliyat edilen 17 hasta retrospektif olarak deðerlendirildi. Tümörlerin yaþý, cinsiyeti, tümör-lenf nodu-metastaz (TNM) evresi, derecesi, invazyon derinliði ve tomografi (BT) hacmi analiz edildi. Bu parametreler ile servikal lenf nodu metastazý arasýndaki iliþki belirlendi.
Bulgular: Otuz iki hastada (%29.91) servikal lenf nodu pozitifliði vardý. Az diferansiye tümörlerin 13'ünde (%46.43), orta-iyi diferansiye tümörlerin 19'unda (%24.05) lenf nodu metastazý saptandý. Lenf nodu negatif hastalarda ortalama hacim 2.15±0.14 cc, lenf nodu pozitif hastalarda ise 2.97±1.05 cc idi. Lenf nodu negatif hastalarda ortalama invazyon derinliði 10.1±0.87 mm, lenf nodu pozitif hastalarda ise 11.3±1.05 mm idi. Larinks skuamöz hücreli karsinomlu hastalarda tümör derecesi ve hacmi lenf nodu metastazýný baþarýlý bir þekilde öngördü ancak invazyon derinliði nodal metastaz ile iliþkili deðildi (sýrasýyla p=0.047, p=0.0022, p=0.916)
Sonuç: Larenks skuamöz hücreli karsinomlu hastalarda tümör derecesi ve hacmi servikal lenf nodu metastazýný öngörebilirken, invazyon derinliði öngörmemektedir. Tümör hacminin radyolojik olarak hesaplanmasý, patologlarýn yaptýðý invazyon derinliði gibi ölçümlerdeki deðiþkenliði en aza indirerek lenf nodu metastazýný öngörmeye yardýmcý olabilir. (SETB-2024-05-085)